It may become all too common in the current 2019 coronavirus disease (COVID-19) crisis that children and families will be confronted with the death of a loved one. More common still may be news of a death in their extended social contacts, and it is virtually unavoidable that children will learn of deaths in the community.
“While news of deaths in extended social circles or in the community may well cause difficult feelings, including anxiety and sadness, children are likely to feel the most intense grief in response to the loss of immediate or extended family members,” says Eric Lewandowski, PhD, clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone and member of its Child Study Center.
Together with the Department of Child and Adolescent Psychiatry’s WonderLab, Dr. Lewandowski offers advice for parents on how to help their children work through the death of a loved one.
Helping Your Child Manage Their Feelings
Even under normal circumstances, death triggers many feelings, including sadness, longing, fear, and anger. “As painful an experience as it is, it can be helpful to remember that death of a loved one is a universal experience that everyone faces at one time or another, and it is an experience that we are equipped to manage,” Dr. Lewandowski says. “It may be reassuring for parents to know that the process of grieving usually happens on its own.”
For most children, all that is needed is the support of loved ones, Dr. Lewandowski adds. “Every child, and person, may differ specifically in what they feel in response to a death,” he says. “There is no one right or normal way that your child is meant to experience their grief, and there is no one right way for you to offer support.”
The experience of sadness and longing at the death of a loved one, while painful, is in fact essential for coping. “As much as we want to protect our kids from this pain, it’s really impossible to do and isn’t even advisable—experiencing these emotions is one of the most important things that children, and all of us, need to do when a loved one dies,” Dr. Lewandowski says. “What is most needed is to meet your child in whatever they are feeling, to provide a chance to talk about the person who died and their feelings about the death, and to validate and normalize their experience.”
Usually sadness and longing are relatively easy to validate. Other emotions, like anger, including at the person who died or at the child’s parents, can be more challenging to validate but are no less important. “These feelings are part of a normal grief response, and parents should strive to be accepting of them,” Dr. Lewandowski says. “Usually, these feelings evolve over time and become less distressing as kids begin to re-engage in other aspects of life.”
Explaining Death to Your Child
To help with this process, when learning that a loved one has died, kids should be provided the essential facts about the death and the circumstances and have an opportunity to ask questions, as often as necessary. “Graphic details should be omitted. The goal is to provide an age-appropriate understanding of what happened so that children can begin to come to terms with the finality and consequences of the death,” Dr. Lewandowski says.
Young children may need some explanation about what death means. “There are no right words, but it’s important to convey that it is a permanent state and that people can’t come back from it,” Dr. Lewandowski says. “Also, it’s important to use the words death or died, rather than other language like ‘passed away’ as this may leave room for confusion about what has happened.”
Some examples of how to communicate to younger children what death is may include that it happens when a person’s body gets very sick—but not like a cold—and stops working; that it doesn’t breathe anymore or need to eat; it doesn’t hurt; and that it means that the person can’t come back. “The specific words you use don’t really matter, it’s the message that counts,” Dr. Lewandowski says. “Parents should check in intermittently so that kids understand that they can talk at any time about anything that is upsetting them about the death, but they should not be forced to talk about their grief or the person who died if they don’t want to.”
Helping Your Child Move Forward
Following a death, and especially in the context of the COVID-19 pandemic, children may worry about what may happen to them or their surviving loved ones and others in the community. Parents should provide reassurance whenever possible about the precautions that are being taken to keep them and their loved ones safe. “When satisfying reassurances are not possible, instead focus on the steps that are being taken by your family, and in the community, to cope with the challenges at hand,” Dr. Lewandowski says.
The vast majority of kids, and people, are able to come to terms with the death and resume a life that has the potential for joy and satisfaction. “Parents should keep family routines as intact as possible, and also make sure to plan opportunities for fun or other positive experiences, either together as a family, or for their child with peers,” Dr. Lewandowski says.
Positive experiences, fun, and enjoyment are very important in supporting a child’s adjustment to a death in the family, and should be encouraged, letting them know that life will continue and that it is OK to have fun and to laugh. “The COVID-19 crisis presents new obstacles in this process, but the activities and opportunities for fun need not be extraordinary,” Dr. Lewandowski says. “Shared activities with siblings or family members, and even solitary engagement in other pleasant or enjoyable activity can be helpful. Keep in mind that youth, especially younger kids, may spend more time engaged in play rather than overt grieving. A helpful rule of thumb is that kids who appear to be coping well are likely coping well.”
Many families may face the additional pain in an already heartbreaking situation of being unable to say goodbye to a loved one who is dying, to be together in such difficult times, or to go through the usual rites, like a funeral. “Such important times have been disrupted by the COVID-19 pandemic, and it can be helpful to find alternative ways to come together to say farewell and to commemorate the person who died,” Dr. Lewandowski says. “Families may conduct a ritual or ceremony, an acknowledgement at a meal, or multiple meals, or virtual gathering, and of course a plan for after the crisis breaks to gather in person for the same purpose.”
Identifying the Need for More Help
The death of a loved one can be a profoundly painful experience, and in the immediate time afterward, it can be hard to distinguish between what is within the norm and what may need attention of a mental health professional. In the vast majority of cases, grieving children, and adults, are able to cope with the support of their loved ones and will not need professional support.
“While some of signs of depression and anxiety are commonplace in grief response, it is important to watch for signs that the sadness about the loss is having a broader impact on the child’s outlook on life or has seemed to impact his or her ability to participate in or enjoy other aspects,” Dr. Lewandowski says. “If a child’s grief seems not to have eased after a period of six months, they may benefit from extra support.”
Similarly, shorter periods of disruptions in sleep, eating habits, or attention to personal hygiene, may also signify the need to extra support. Finally, the emergence of suicidal thinking or self-harming indicates a need for consultation with a professional.
It can be difficult to make these distinctions, and parents should not feel they need to worry alone, Dr. Lewandowski says. Consulting with a professional, including mental health experts at NYU Langone, can provide reassurance that will help families continue their own coping, and can identify signs that more support is necessary. “Caregiver wellbeing is the most important factor in supporting kids through the death of a loved, and parents themselves should be encouraged to seek any support they need for themselves,” Dr. Lewandowski adds.
Additional Resources for Parents
Dr. Lewandowski suggest the following resources for parents to help their children with the death of a loved one: